No abstract available.
Puberty, Precocious* ; Sertoli-Leydig Cell Tumor*

We have recently encounted a case of Kasabach-Merritt syndrome which were characterized by hemangioma, thrombocytopenia, and disseminated intravascular coagulation. The skin of anterior neck and tongue was involved by large mass of hemangioma. Patient was taken ventilator care from upper airway obstruction of hemangioma. He was placed on combined therapy with steroid and interferon alfa-2a for 13weeks. Blood platelet count increased to acceptable range(>20000/mm3) after 10weeks of interferon alfa-2a treatment and the hemangioma decreased in size. But, he expired from failure of airway maintenance, uncontrollable bleeding and septic shock on hospital day 93. A brief review of the literature ensues with the case report.
Airway Obstruction* ; Disseminated Intravascular Coagulation ; Hemangioma ; Hemorrhage ; Humans ; Interferons* ; Kasabach-Merritt Syndrome* ; Neck ; Platelet Count ; Shock, Septic ; Skin ; Thrombocytopenia ; Tongue ; Ventilators, Mechanical

PURPOSE: This study was performed to investigate the effects of environmental factors, genetic polymor phisms of cytochrome P450 2E1 (CYP2E1) and N-acetyltransferase 2 (NAT2), and their interactions on mutations of p53 and Ki-ras genes in Korean stomach cancer. METHODS: One hundred nine stomach cancer patients and 211 age- and sex-matched controls were enrolled in this study. Direct interview with a structured questionnaire was performed to get informations on the level of exposure to environmental factors. For genotyping of the metabolic enzymes, PCR-RFLP methods were used. RT-PCR and direct sequencing were carried out to detect mutations in the p53 and the Ki-ras genes of stomach cancer tissue. To evaluate the risk of stomach cancer, we calculated odds ratios for environmental and genetic factors, and their combinations. RESULTS: Past medical histories of gastritis, diabetes and asthma allergic rhinitis were significant risk factors for stomach cancer. Fried potatoes, squid and octopus, welsh onions and chestnuts and gingkonuts had protective effects against stomach cancer. On the contrary, chicken, soybean paste stew, and soybean milk were significantly related to an increased stomach cancer risk. The NAT2 rapid acetylator turned out to be a marginally significant risk factor for gastric cancer. Mutations of the p53 and the Ki-ras genes were detected in 27.5% and 10.7% of stomach cancer tissues, respectively. Frizzled rice, potato, beef, lard, pickled fish, chicken stew, anchovies, tempura, Welsh onions, eggs, bean-curd, Qing-style soybean paste stew, and ice cream were protective against p53 mutation whereas yogurt was a risk factor for p53 mutation in stomach cancer tissue. Ki-ras mutation was associated with less intake of pears and persimmons, melons, strawberries, grapes and milk and with more intake ofsoybean paste stew. In a multiple logistic analysis including genetic polymorphism, past medical history and diet intake, past history of gastritis, chicken, soybean paste stew, and soybean milk were significant risk factors for stomach cancer whereas past history of diabetes, squid and octopus, and Welsh onions were protective factors against stomach cancer. CONCLUSION: These results suggest that past medical history and diet are more important risk factors for stomach cancer than genetic polymorphism and that mutations of the p53 and the Ki-ras genes would be induced by the respective risk factors.
Asthma ; Carcinogenesis* ; Carcinogens, Environmental* ; Chickens ; Cucurbitaceae ; Cytochrome P-450 CYP2E1* ; Decapodiformes ; Diet ; Diospyros ; Eggs ; Fragaria ; Gastritis ; Genes, ras ; Humans ; Ice Cream ; Milk ; Octopodiformes ; Odds Ratio ; Onions ; Ovum ; Polymorphism, Genetic* ; Pyrus ; Surveys and Questionnaires ; Rhinitis ; Risk Factors ; Solanum tuberosum ; Soybeans ; Stomach Neoplasms ; Vitis ; Yogurt

Extracellular ATP elicits various biological responses and plays a significant role in physiological regulation. Recently, ATP-induced growth inhibitions were reported in some tumor cell lines, but these effects and mechanisms are not well known. This study was conducted to investigate ATP-induced growth inhibition in mouse leukemic (P388D,) cells. ATP inhibited cell growth in a dose-dependent manner as analyzed by MTS assay (IC50: 33.1 muM). Nucleotides other than ATP, such as ADP (37.5 muM) and AMP (33.2 muM) had the same effects as ATP, but adenosine (57.8 muM) showed less effect than ATP. ATP attenuated the cells in G0/G1 and G2/M phases, but increased those in S phase in flow cytometric analysis. Hypodiploid cells (A0), the presumptive findings of apoptosis, were found among the ATP-treated cells. ATP induced DNA fragmentation into 180 ~ 200 bps as measured by electrophoresis. Some apoptotic cells were stained by TUNEL method. ATP increased the intracellular free Ca++ concentration ((Ca++)i) and the increment of (Ca++)i was caused by influx from the extracellular space. These results suggest that extracellular ATP induces growth inhibition through apoptosis.
Adenosine Diphosphate ; Adenosine Triphosphate ; Adenosine* ; Animals ; Apoptosis* ; Cell Line, Tumor ; DNA Fragmentation ; Electrophoresis ; Extracellular Space ; In Situ Nick-End Labeling ; Mice* ; Nucleotides ; S Phase

PURPOSE: Developing a curriculum(DACUM) is a method of analyzing job focused competency, which is obtained from the data of an expert belonging to a certain career. In this study the DACUM method was used to analyze the jobs of operating room nurses. METHOD: Through the DACUM workshop which was arranged by two DACUM facillitators, a definition of the role of operating room nurses was developed and then duties and tasks of operating room nurses' were identified. For the workshop, a DACUM committee with 10 operating room nurses was organized. Finally, the duties and tasks which were identified were validated by 422 nurses for importance, difficulty, and frequency. RESULTS: Thirteen duties and 105 tasks were identified on the DACUM chart, where importance, difficulty, and frequency of tasks were represented by alphabet letters A, B, and C as higher degree of importance. The determinant coefficient(DC) showed that the most important duty was assisting with operations(DC=6.61), and the least, managing operating materials(DC=4.22). For tasks, the most important ones were assisting in orthostatic surgery(DC=7.60), and assisting in thoracic surgery(DC=7.38), and the least important making gauze ball(DC=2.39), and saving of operation site((DC=3.27). CONCLUSION: The results suggest a need to develop an education program using the DACUM chart as a basis for the development and as a clinical career ladder and for curriculum of operating room nursing.
Career Mobility ; Curriculum ; Job Description ; Operating Room Nursing ; Operating Rooms

PURPOSE: This study was conducted to describe qualitatively the entities of nurse's experiences in general hospitals and to suggest basic data guiding research on developing Standards of clinical nursing practice in Korea. METHOD: Fourteen nurses working at general hospitals with over 300 beds in Seoul were interviewed in-depth until saturation using tape-recorders and transcription. RESULT: The central theme of clinical nursing practice experienced by subjects was "being with clients" that means accepting client's personal character, solving client's needs and providing client-centered nursing. A also "being with clients" was felt to be the responsibility of nurses which was learned from their nursing schools. The nursing strategies performed in order to be with patients were proving skillful nursing techniques, accepting, educating, emotional support, advocating, and self-reflecting, the subjects experienced somewhat problematic affects such as difficulties in interpersonal relationship, work overload, negative image of nursing, deficit of self-confidence for nursing actions, poor working conditions, and unfair treatment. Nurses at the hospital practiced with pride when they felt that they were accepted by clients. CONCLUSION: Further research is needed to analysis problems in clinical practice and the comparison of nurses' experiences of clinical practice, with nurses' experiences in various settings.
Hospitals, General ; Humans ; Korea ; Nursing ; Schools, Nursing ; Seoul

PURPOSE: This study was done to evaluate the formal education program provided by the Korean government for care workers for frail elderly people. METHODS: This study was a cross-sectional survey in which 438 certified care workers who had completed the education program participated. Data were collected from June to October 2009, using a self-report questionnaire consisting of satisfaction with, and understanding of the education program. RESULTS: The participants had a mean age of 46.7 yr, 87.9% were female and 58.2% were high school graduates. For the theory part of the education, the highest score for understanding was for 'supporting household & activities of daily living' while the lowest score for understanding was for 'care for death and dying'. For the practical education, the highest score for understanding was for 'talking with the client' and the lowest score was for 'first aid & basic life support'. There was a significant difference in satisfaction and understanding of the theoretical and practical parts according to educational level. CONCLUSION: Continuing education programs are needed for care workers for elders, both in the theoretical and practical areas. Also the content of programs should address the weak points of this formal education program.
Adult ; Aged ; Caregivers/*education/psychology ; Cross-Sectional Studies ; Education, Nursing, Continuing ; Female ; Frail Elderly ; Humans ; Male ; Middle Aged ; Program Evaluation ; Questionnaires ; Republic of Korea

PURPOSE: The aim of this study was to evaluate the changes of the regulatory T cell subset in peripheral blood caused by gestational age and premature rupture of membranes (PROM) with or without labor to verify the role of regulatory T cells in pregnancy. PATIENTS AND METHODS: We investigated regulatory T cell distribution in the peripheral blood of pregnancies during the first trimester (group I, n=2), the second trimester (group II, n=12), and the third trimester without PROM and labor (group III, n=15). In addition, we evaluated pregnancies in the third trimester complicated by PROM (group IV, n=4) and labor with no complication by PROM (Group V, n=5). Comparisons were made with non-pregnant controls (group VI, n=4) using flow cytometry. RESULTS: During uncomplicated pregnancy, the CD4(+)CD25(bright) regulatory T cell population decreased with advancing gestational age (group I=3.35+/-0.47, group II=2.91+/-1.44, group III=2.81+/-1.36, group VI=2.52+/-0.71, p=NS). When we compared group IV with group III and V to evaluate the changes of the regulatory T cells with PROM, the CD4(+)CD25(bright) regulatory T cell population was significantly decreased in group IV compared to group III (p=0.001) and group V (p=0.026). CONCLUSION: The present results revealed that the regulatory T cell population increased in early pregnancy but decreased in pregnancies complicated by PROM, indicating that regulatory T cells might be related to the maintenance of pregnancy.
Antigens, CD4/immunology ; Female ; Fetal Membranes, Premature Rupture/*immunology/physiopathology ; Gestational Age ; Humans ; Interleukin-2 Receptor alpha Subunit/*immunology ; Labor, Obstetric/*immunology/physiology ; Pregnancy ; T-Lymphocytes, Regulatory/*immunology/physiology

BACKGROUND: Recently obese people have increased in Korea due to change of diet and life style. Obesity itself is an independent risk factor of cardiovascular disease. Also, obesity is associated with hyper tension, dyslipidemia, and diabetes as a componet of insulin resistance syndrome. To assess the health implications of obesity, we investigated the prevalence of obesity and the correlation between obesity and dyslipidemia. METHOD: The study was conducted in 1,733 elderly Korean(male 346, female 1,387) who lived in southwest Seoul area. Subjects were checked sex, age, height, weight, waist circumference, hip circumference blood pressure, serum total cholesterol, triglyceride, HDL cholesterol and LDL cholesterol. Overall obesity was measured by BMI(body mass index) and abdominal obesity was evaluated by WHR(waist-to-hip ratio). Subjects were divided according to their BMI(<25.0, > or = 25.0) and WHR(male< or =0.90, > or =0.90/female< or =0.85, > or =0.85). RESULT: The prevalence of obesity according to BMI was 32.1% in men and 46.4% in women. Systolic and diatolic blood pressure, total cholesterol, triglyceride, LCD cholesterol in the obese group revealed significantly higher than those in the nonobese group. In the abdominal obesity male group according to WHRl, the serum tiglyceride level was increased and the serum cholesterol level was decrea- sed but blood pressure, total cholesterol and LDL cholesterol were not different compared with the non-obese group. In the abdominal obesity female group, sys- tolic and diastolic blood pressure was significantly different in addition to triglyceride and HDL cholesterol compared with the non-obese group. CONCLUSION: Obese Korean elderly population had a characteristics like higher levels of blood pressure, serum total cholesterol, triglyceride and lower level of HDL cholesterol. which were known as cardiovascular risk factors. To evaluate the correla- tion between obesity and cardiovascular risk, prospective study for the difference of incidence of cardiovascular disease between obese and non-obese group will be continued.
Aged* ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Diet ; Dyslipidemias* ; Female ; Hip ; Humans ; Hypertension ; Incidence ; Insulin Resistance ; Korea ; Life Style ; Male ; Obesity* ; Obesity, Abdominal ; Prevalence* ; Risk Factors ; Seoul* ; Triglycerides ; Waist Circumference ; Waist-Hip Ratio

Pigmentation may result from melanocyte proliferation, melanogenesis, migration or increases in dendricity. Recently, it has been reported that secreted phospholipase A2(sPLA2) known as a component of bee venom (BV), stimulates melanocyte dendricity and pigmentation. BV has been used clinically to control rheumatoid arthritis and to ameliorate pain via its anti-inflammatory and antinociceptive properties. Moreover, after treatment with BV, pigmentation around the injection sites was occasionally observed and the pigmentation lasted a few months. However, no study has been done about the effect of BV on melanocytes. Thus, in the present study, we examined the effect of BV on the proliferation, melanogenesis, dendricity and migration in normal human melanocytes and its signal transduction. BV increased the number of melanocytes dose and time dependently through PKA, ERK, and PI3K/Akt activation. The level of cAMP was also increased by BV treatment. Moreover, BV induced melanogenesis through increased tyrosinase expression. Furthermore, BV induced melanocyte dendricity and migration through PLA2activation. Overall, in this study, we demonstrated that BV may have an effect on the melanocyte proliferation, melanogenesis, dendricity and migration through complex signaling pathways in vitro, responsible for the pigmentation. Thus, our study suggests a possibility that BV may be developed as a therapeutic drug for inducing repigmentation in vitiligo skin.
Animals ; Base Sequence ; Bee Venoms/*pharmacology ; Cell Movement/drug effects ; Cell Proliferation/drug effects ; Cells, Cultured ; Cyclic AMP/metabolism ; DNA Primers/genetics ; Forskolin/pharmacology ; Gene Expression/drug effects ; Humans ; Melanins/biosynthesis ; Melanocytes/cytology/*drug effects/physiology ; Microphthalmia-Associated Transcription Factor/biosynthesis/genetics ; Monophenol Monooxygenase/biosynthesis/genetics ; Signal Transduction/drug effects